Provider Demographics
NPI:1437140373
Name:DAVID, ALEX S (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:S
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 17930
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72222-7930
Mailing Address - Country:US
Mailing Address - Phone:501-663-0490
Mailing Address - Fax:501-663-5948
Practice Address - Street 1:8907 KANIS RD STE 330
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6451
Practice Address - Country:US
Practice Address - Phone:501-224-8810
Practice Address - Fax:501-224-9076
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC-7911207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5J856OtherBLUE CROSS BLUE SHIELD
AR127777001Medicaid
AR5J856Medicare PIN
G12436Medicare UPIN